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Building Department <br /> p f- <br /> late Received Z_- 1 S7c) Phone Contact for Permitting <br /> - <br /> )wnees.Name p�L�kc �' D(11L Cv )G�.11L C.(-� Owner Phone Number <br /> )wner's Address 2 �Ikeilburq 01. 4f I,i'le Owner Phone Number <br /> ee Simple Titleholder Name / r Owner Phone Number <br /> °ee Simple Titleholder Address <br /> IOB ADDRESS 3�f !J p LOT# <br /> WISDIVISIO.N" QW�SD aSliD PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> YORK PROPOSED ® NEW CONSTR 8 ADDIALT = SIGN Q DEMOLISH <br /> INSTALL REPAIR <br /> )ROPOSED USE FX7 SFR 0 COMM = OTHER <br /> TYPE OF CONSTRUCTION 11 BLOCK FRAME STEEL /Q <br /> )ESCRIPTION OF WORK ` <br /> 3UILDING SIZE SQ'FOOTAGE HEIGHT <br /> =BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL $ ' ny1 AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.Al <br /> ✓✓ V vLA <br /> =PLUMBING $ / ®' J1 <br /> (O <br /> =MECHANICAL $r /� VALUATION OF MECHANICAL INSTALLATION" . <br /> =GAS = -ROOFING SPECIALTY = OTHER <br /> FINISHED FLOOR ELEVATIONS j FLOOD ZONE AREA =YES NO" <br /> -4,q1 <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N__J FEE CURREN Y/N . <br /> Address � n lVe'yfi License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y I N FEE CURREN Y/N <br /> Address 6 ! [� �/ �� ! License# t0 <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED YIN FEE CURREN <br /> Address:. 313�/�j�3 . GJrlc�� /iFL_�✓f,�78� License# C- '7-7" <br /> MECHANICAL COMPANY 1/1,46 AY Cr7'd h A`1 x r//) <br /> SIGNATURE REGISTERED I Y/ N _ j FEE CURRE<\ I Y/N <br /> �/3 17Gr1Y6Y1 Atl�� RSLy1,.FL 3c((P(o7 License# 3 2�Address <br /> OTHER COMPANY ''` r�" I// aL <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y'/N <br /> /1931�i7/in-J�r e!J Off icll ,3 •L°/3� 5 <br /> Address i License# 3 <br /> rrrrrr .rrr [ [ rr [ [ r [ rr [ [ rrr" r [ rrr [ r [ r [ [ [. rrr [-r [ [ r [. r.r.[ r [ r.rr-[ rr [ rr. [ [ rrr .[ [ [ <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster;Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach(2)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submittal date. Required"onsite,Construction Plans,Stonmwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&'1 dumpster,Site Work Permit for all new projects.All commercial requirements must meet compliance <br /> .SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> **"PROPERTY SURVEY required for all NEW construction. <br /> Directions: <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over$2500,a Notice of.Commencement is required. (A/C upgrades over$7500) <br /> 'Agent(for the contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (copy of contract required) <br /> Remofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />